cardio 3 Flashcards
white clot syndrome, associated with increased use of heparin,
heparin induced thrombocytopenia and thrombosis
what does the spleen do with blood
removes old and defective RBCs from circulation, returns iron from Hgb to bone marrow for reuse, storage for platelet mass (30%)
malignant change in lymphocytes causing tumors in lymphoid tissue
lymphoma
disease in which gastric mucosa is not secreting IF bc of antibodies being directly against the gastric parietal cells and or IF itself
pernicious anemia
what populations are affected by iron deficiency anemia
pregant, menstrating women
infants, children adolescents
those with poor diets
cardiac output =
stroke volume x HR
one of the most common hematological disorders world wide
iron deficiency anemia
what begins the clotting process
platelets
disease confined to only one lymph node or region
Stage I
thr force exerted by the blood against the walls of blood vessels
blood pressure
painless moveable enlarged lymph nodes on one side of the body
hodgkins lymphoma
if a pts hemoglobin is below 8 what must be done
place pt on 3 liters via NC
what blood product would you need to control or prevent bleeding caused by thrombocytopenia
(30-50ml bag infused over 30-60 minutes)
platelets
carry fluid to lympatic duct or thoracic duct
lymph capillaries
what system works through diffusion and carries fluid from interstital space to blood, preventing edema
lymph system
known as “silent killer”
HTN
filter bacteria and foreign particles
lymph nodes
how do the kidneys assiste with BP control
by regulating sodium and fluid volume
charcterized by debilitating fatigue with a variety of complaints
chronic fatigue syndrome
abnormal destruction of circulating platelets
immune thrombocytopenia puroura
normal lifespan is 8-10 days with ITP 1-3 days, destrucion exceeds production
what is given for Lymes disease
amoxicillin po 2-3 weeks
normal WBC count
4-11
Rh+ can
receive any blood
the spleen produces what during fetal development
RBCs
drains into subclavin vein
lymph duct
arterial BP =
CO x systemic vascular resistance
when you have a HTN emergency what do you not want to do
lower BP too quickly, decrease mean arterial pressure by no more than 25% inone hour
over production and accumulation of functionally inactive lymphocyte due to genetic mutation
chronic lymphocytic leukemia
Rh-cannot recieve
+ blood
normal hematocrit
women 38-47%
men 40-54%
what blood product whould you need to increase O2 carrying capacity without volume (most common)
RBC
occurs in bone marrow, liver and slpeen.
hemolysis, erthrocyte destruction
what is associated with under production of RBCs and decrease of survival of the RBCs
anemia of chronic diseses, RBCs survive less than 120 days
group of disorders characterized by large and abnormal RBCs
megaloblastic anemia
what is the most common site for a bone marrow study
posterior iliac crest
Hgb 6-10
moderate anemia
tachycardia, dyspnea, diaphoresis, pallor
if you have a decrease in BP that activates what
sympathetic nervous system
excessive bone marrow production of erythrocytes, leukocytes and platelets which results in increased blood viscosity and volume
polycythemia
megaloblastic anemia is due to
vitamin deficiencies such as Vit B 12 and folic acid
signs and symptoms of polycythemia
pruitus, increased clotting, enlarged liver and spleen, bleeding, GOUT, CVA
the reduction of platelets below level needed for normal blood clotting (below 150,000)
thrombocytopenia
what WBC is first to arrive at the injury site, an increase of these could mean infection or tissue injury
neutrophils
if you are Rh+ you can donate to and receive from?
donate to RH+
recive from Rh+, Rh-
usually ABO incompatibility
acute hemolytic
Hgb less than 6
severe anemia
hypotension, heart failure
immature RBC
reticulocyte, they mature in 48 hours to a erythrocyte
what is the dagnosis of hodgkins
biopsy with reed sternberg cells
how is lymphoma staged
with roman numeral I-IV (which reflects location and extent) and with A or B ( either absence of or symptoms present)
enlarged spleen, decrease of RBCs, WBCs, and platelets
splenomegaly
folic acid deficiency is very common and folic acid is needed for what
normal DNA synthesis of erythropoiesis
lymohangitis
inflammation of one or more lymphatic vessels, often seen in arms or legs
what gives protection from invading organisms
WBCs (leukocytes)
what are the two major compoents of blood
plasma, blood cells
blood administration process
baseline VS (within 15 minutes)
check PT ID
begin slowly (50ml/hr for 1st 15 min then incrsae to 125ml/h)
monitor pt q15initially then once/hr
transfuse in less than 4 hours
flush line with ND & d/c
complete paperwork
transfusion report to blood bank
relaxes vascular smooth muscle producing vasodilation
vasodilators
what WBC is formed during allergic response to allergen
eosinophils
what WBC is responsible for immune response, B cells and T cells
lymphocytes
what is the most characteristic sign of lyme
erythema migrans (bulls eye rash)
impaired production of RBCs, bone marrow is severly hypocellular, pancytopenia develops
aplastic anemia
decrease in total WBC count
leukopeina
what medication for HTN is not prescribed for patients with respiratory disorders
non selective beta blockers
what is the most commonly occurring hematologic cancer
non hodgkins lymphoma
sustained elevation of BP over 140/90 or use of anti-hypertensives in adults over 18y, average of 2 or more BP properly measured while sitting on at least 2 visits
HTN
what does the RAAS (renin angiotensin aldosterone system) do
decreases blood flow thorugh kidneys (holds onto sodium and H2O which increase blood volume and increase cardiac output
reticulocyte count measures
the rate at which RBCs appear in circulation
diease involving node on both sides of the diaphragm
Stage III
pancytopenia
low count of RBC, WBC and platelets
in the endocrine system, the stimulation of the SNS stimulates the release of epi/norepi which does what
increases HR & myocardial activity (CO) and causes vasoconstriction
what disease is the spread unpredictable, can originate outside of the lymph nodes and has a poor prognosis
non hodgkins lymphoma
what blood product would you need for treatment of massive blood loss, bc of the O2 carrying capability and volume
whole blood
if you are Rh- you can donate to and receive from?
donate to Rh-
reveive from Rh-
signs symptoms of anemia
pallor, pruitus, jaundice, glossitis (enlarged shiny tongue), tachycardia, increase RR, HA, vertigo, bone pain
what is the % of ingested iron is actually absorbed
5-10%
what is the function of the lymph system
lymph vessels transfer lymph -excess fluid from tissues
what WBC is a potent phagocytic cell tha tengulfs bacteria, dead cells, tissue debris and defective RBCs and is the 2nd type of WBC to arrive at the injury site
monocyte
where is the spleen located
LUQ
when giving blood products what must happen
2 nurses must sign transfusion record, only NS can be used to prime blood tubing before blood arrives
blood cell production
hematopoiesis
what is the most common vector born disease in the US
lyme
lymphadenitis
inflammation of one or more lymph nodes
ACE inhibitors blocks what
RAAS
possible signs and symptoms of lyme
bulls eye rash, chronic arthritic pain, HA, bells palsy
increase in total # of WBCs due to acute infection, tissue damage/dath leukemias
neutrophilia (leukocytosis)
normal range for hemohlobin
women 12-16
men 13.5-18
what test is used for the Rh factor
coombs test
if you are B you can donate to and receive from?
donate to B, AB
receive from O, B
becomes red with combined with O2, made of iron (heme) and protein and amino acids (binds with O2 and CO2)
hemoglobin
what is a sign of hemolytic aneima
enlarged spleen and liver
what is a symptom of HTN emergency syndrome
epistaxis
total blood flow through the systmeic or pulmonary circulation each minute
cardiac output
transmitted by bite of infected deer tick
lyme disease
what are the 3 main causes of anemia
blood loss
decresased productoio of erythrocytes
increased destruction of erythrocytes
normal BP
less than 120/80
endotheila cells line the intima of the blood vessels and generage vasoactive substances such as nitric oxide, endothelin and prostacyclin
vascular endothelium
whan an acute transfusion reaction occurs you should
stop transfusion
hang hew tubing NS kvo
VS q15 min
notify MD ASAP
notify blood bank, save all supplies and give to them
netropenia
reduced netrophil count of less than 1,000
intrinsic is
extrinsic is
hereditary
acquired (more common) trauma, infectious agents, iso-autoimmune reactions
platelets clump in capillaries, medical emergency bc bleeding and clotting occur simultaneously
thrombotic thrombocytopenic purpura
lymphadenopathy
disease of lymph nodes
what kind of patients will most likely have thrombocytopenia
chemo pts
blood products have to be hung within _____ and transfusion must be complete within _____
30 minutes
4 hours
what diagnosis’s lyme
lyme titer
prevents angiotensin II fro binding to receptor site on wall of blood vessel
angiotensin II receptor blocker (ARBs)
if you have an increase of diameter of a blood vessel you have a _______ of pressure
decrease
what are causes of iron deficiency
inadequate diet, malabsorption, blood loss
when hemoglobin is destroyed its parts are reused how?
heme is broken to bilirubin and iron (recycled), and globin breaks down into amino acids to build proteins
what is the only accurate way to measure BP
intra arterial catheter
how do neutropenic pts get most of their infections
health care providers, so wash your hands!
cheilitis
inflammation of lips (can happen with iron deficency)
leukopenia
less than 4,000
erythrocytes
o2 transport
what do you do with someone disgnosed with heparin induced thrombocytopenia and thrombosis
discontinue heparin (heparin and lovonox are now allergies), give protamine sulfate
what WBC releases heparin, serotonin and histamines, and is a allergic and inflammatory reaction
basophils
what is the most common symptom of HTN
asymptomatic
Rh+ has
D antigen on RBC, Rh- doesnt
epistaxis
nose bleed
if you are AB you can donate to and receive from?
donate to AB
recieve from A, B, O, AB
the life span of a RBC is
120 days
what do macrophages do
remove abnormal, defective and damaged RBCs from circulation
what is a treatment for GOUT
allopurinol
leukocytes
infection protection
thrombocytes
promote coagulation
leukocytes are
WBCs
granulocytes
*neutrophils, basophils, eosinophils
agranulocytes
*lymphocytes, monocytes
what mechanisms regulate BP
cardiac output
systemic vascular resistance
blood product needed to increase level of clotting factors in pts with a deficiency
fresh frozen plasma
where is the liver found
RUQ
excess circulating platelets, may lead to clot formation, caused by elevated platelet production in bone marrow
thrombocytosis
where is vitamin K stored and what does it do
stored in fatty tissue and in liver
assists in coagulation
what is the unerversal donor blood type
O-
sensitive to leukocytes in blood, seen in multiple transusions
febrile non hemolytic
PTs with cobalamin deficiency (Vit B 12) are at a high risk for what and what must they doas a life time therapy
gastric cancer
life long monthly B12 injections
anemia of acute blood loss is a result of
sudden hemmorrhage, major comlication is shock, body needs 2-5 days to replace loss
red marrow produces
hematopoietic stem cells that mature to become erythrocytes, leukocytes and platelets
blood clotting maintains the integrity of the body when there is injury
hemostasis
what is the most common symptom of thrombocytopenia
bleeding
study of blood and blood forming tissue
hematology
what is netropenia commonly caused by
chemo and immunosuppressive Rxs
in order to be diagnosed with chronic fatigue syndrome you must meet what criteria
have unexplained chronic fatigue
not due to ongoing exertion
not alleciated by rest
results in reduction of activities
plus 4 other complaints such as, short term memory loss, sore throat, musle pain, jopint pain, HA
extra nodal disease, usually liver or bone marrow
Stage IV
destruction or hemolysis of RBCs at a rate that exceeds production
hemolytic anemia, caused by intrinsic or extrinic reasons
RBC function
tranport o2 and CO2 and assist in acid base balance
what are the 2 main actions of HTN Rxs
reduces SVR, reduces volume of circulating blood
the force opposing the movement of blood
vascular resistance
what is the universal recipient for blood
AB-
If you are O you can donate to? and recieve from?
donate to A, B, AB, O
recieve from O
disease confined to 2 or more nodal regions onthe same side of the diaphragm
Stage II
what blood product is used for hypovolemic shock and hypoalbuminemia
albumin
what is needed after a splenectomy
pneumococcal vaccine, monitor for hemorrhage and shock
anemia of chronic blood loss occurs because of
the iron stores are depleted
what dont you do for someone with thrombotic thrombocytopenic purpura
give platelets
what size needle is needed for blood transfusion
20 gauge or larger
group of hematologic disorders characterized by change in quantity and quality of bone marrow elements
myelodysplastic syndrome (MDS)
treatments for thrombocytopenia
corticosteroids (for unknown) platelet transfusions, neumga (platelet growth factor)
Hgb 10-14
mild anemia
may have no complaints or C/O palpitations, dyspnea, fatigue
average SBO greater to or equal to 140 coupled with an average of DBO less than 90, loss of elasticity in arteries
isolated systolic HTN
what are the three major functions of blood
transportation (o2, nutrients, waste products), regulation (fluid, temp) and protection (clotting, combat infection)
if you have a decrease of diameter of blood vessel you have a ________ of pressure
increase
what does the liver do with blood
stores iron, produces procoagulants essential to hemostsis and blood coagulation
deficiency in # of erythrocytes, quantity of hemoglobin, volume of packed RBCs
anemia
symptoms of HA, N?V, seizuers, confusion
HTN ecephalopathy
what stiulates bone marrow to increase RBC production
erythropoiesis
what aids in clotting bloot, and is activated at site of any tissue or vessel damage
platelets (thrombocytes)
increase of iron, liver enlarges and develops cirrhosis
hemochromatosis
normal platelet count
150,000-400,000
what is the average amount of blood you should have
5-6 liters
can lab tests diagnosis chronic fatigue syndrome
no
what medications are given for HTN
diuretics, adrenergic inhibitors, vasodialtors, ACE inhibitors, calcium channel blockers, angiotensin inhibitors
blocks movement of calcium into cells of blood vessels
calcium channel blockers
radiologic visualization of the lymph system after injecting contrast medium
lymphangiography
what blood product is removed from FFP and contains clotting factors
cryoprecipitate
purpura
clumping of petechiae
if you are A you can donate to and receive from?
donate to A, AB
recieve from O, A
